{ "schemaVersion": 2, "eyebrow": "Orthopedic Trauma", "title": "Colles Fracture", "summary": "Manage Colles fracture by identifying open, neurovascular, and unstable injuries; obtaining post-reduction alignment; then matching cast treatment or fixation to displacement, articular involvement, instability, functional demand, and the likelihood that loss of reduction would change management.", "seoDescription": "Point-of-care management of Colles fracture, including reduction, radiographic thresholds, cast follow-up, surgical selection, timing, and complications.", "clinicalQuestion": "How should clinicians reduce, risk-stratify, monitor, and select fixation for an adult Colles fracture?", "specialty": "Orthopedic Surgery", "audience": "U.S. physicians and medical trainees", "tags": [ "Colles fracture", "distal radius fracture", "closed reduction", "volar locking plate", "wrist fracture", "cast immobilization" ], "keyTakeaways": [ "Treat open fracture or neurovascular deficit as an urgent operative-pathway injury; document and reassess median nerve and distal perfusion before and after reduction or splinting. [20]", "For non-geriatric patients, post-reduction radial shortening greater than 3 mm, dorsal tilt greater than 10 degrees, or intra-articular step-off greater than 2 mm supports operative fixation. [18]", "In patients 65 years or older, surgery improves radiographic alignment but has not shown superior long-term patient-reported outcomes versus nonoperative treatment; functional demand and ability to tolerate deformity should drive shared decisions. [18][4]", "Repeat wrist radiographs at 1 to 2 weeks only when fracture instability is present and displacement would alter management; stable fractures do not require routine interval imaging. [20]", "When fixation is selected, target surgery within 72 hours for intra-articular fractures and within 1 week for extra-articular fractures. [20]" ], "sections": [ { "id": "initial-triage", "eyebrow": "Emergency Decisions", "heading": "Identify injuries that cannot wait for routine casting", "intro": "Prioritize limb status and fracture complexity before choosing definitive stabilization.", "paragraphs": [ "A Colles fracture is a distal radius fracture with dorsal displacement and angulation of the distal fragment, usually after a fall on an outstretched hand. Obtain wrist radiographs and assess whether the injury is extra-articular or extends into the radiocarpal or distal radioulnar joint; involvement of the sigmoid notch can alter distal radioulnar joint biomechanics and may lead to pain, instability, or restricted forearm rotation if healed with a step or gap. [22][9]", "Before and after any manipulation, record digital perfusion and a focused neurologic examination, particularly median nerve function. Open fracture, neurovascular deficit, marked displacement, and unstable fracture morphology are indications to move beyond routine outpatient cast management and consider operative stabilization. [20]", "Place an acutely displaced fracture on a reduction pathway when restoring alignment is feasible and subsequent treatment depends on post-reduction radiographs. Splint after reduction rather than applying a circumferential acute cast when swelling risk is material; excessive pain, finger paresthesias, or digit discoloration in immobilization requires immediate reassessment for a constrictive splint or cast. [22]" ], "bullets": [ "Obtain and document post-reduction radiographs before disposition when reduction is performed; treatment selection depends on residual shortening, tilt, and articular incongruity. [18][20]", "Escalate urgently for open injury, vascular compromise, or neurologic deficit rather than relying on serial outpatient radiographs. [20]", "Assess distal radioulnar joint symptoms and forearm rotation when the fracture line involves the sigmoid notch. [9]" ], "subsections": [], "table": { "caption": "Initial triage features that change the immediate management pathway. [20][9]", "columns": [ "Finding", "Interpretation", "Next action" ], "rows": [ [ "Open fracture or neurovascular deficit", "Not a routine closed-cast injury. [20]", "Urgent operative-pathway evaluation; document serial vascular and neurologic findings. [20]" ], [ "Intra-articular extension or sigmoid-notch involvement", "Articular incongruity or distal radioulnar joint injury may affect function and stability. [9][20]", "Assess reduction quality and consider early operative planning if reconstruction is indicated. [20]" ], [ "Severe displacement or unstable pattern", "Higher concern for inadequate maintenance of reduction. [20]", "Reduce, splint, obtain post-reduction films, and determine whether loss of alignment would warrant fixation. [20]" ], [ "Stable, minimally displaced extra-articular fracture", "Often appropriate for nonoperative immobilization. [21][23]", "Immobilize and mobilize early after immobilization is discontinued. [20]" ] ] } }, { "id": "radiographic-selection", "eyebrow": "Alignment", "heading": "Use post-reduction alignment and patient demand to select casting or fixation", "intro": "Age is a proxy for demand, not a substitute for individualized functional goals.", "paragraphs": [ "For non-geriatric adults, the AAOS/ASSH guideline supports operative treatment when post-reduction radial shortening exceeds 3 mm, dorsal tilt exceeds 10 degrees, or intra-articular displacement or step-off exceeds 2 mm. These thresholds are decision aids after reduction, not an indication to operate on every radiographic deformity without considering injury pattern and patient goals. [18]", "For patients 65 years and older, operative fixation does not improve long-term patient-reported outcomes compared with nonoperative treatment, despite better radiographic results. Casting has the least complications and comparable functional outcomes in elderly trial populations, whereas radiographic alignment after closed reduction and the patient's functional demand should determine whether operative stabilization is worthwhile. [18][4]", "In an adult with a closed extra-articular Colles fracture, closed reduction and casting are generally reasonable when residual deformity is limited. One clinical reference uses no more than 5 mm shortening, 5-degree change in radial inclination, 2 mm articular step-off, and 5 degrees angulation as eligibility parameters for closed reduction as primary treatment; use this alongside the AAOS/ASSH thresholds and the patient's age and functional requirements. [23][18]" ], "bullets": [ "Favor fixation in a younger or high-demand patient when residual shortening, dorsal tilt, or articular incongruity exceeds AAOS/ASSH thresholds after reduction. [18]", "In an older low-demand patient, discuss that improved x-ray alignment with surgery may not translate to superior long-term reported function and exposes the patient to surgical complications. [18][4][14]", "Do not use chronologic age alone when an older patient has high hand-function requirements or when a satisfactory reduction cannot be maintained. [4][18]" ], "subsections": [ { "heading": "What instability means operationally", "paragraphs": [ "No single instability factor reliably predicts redisplacement. Use a practical question instead: if interval films show loss of reduction, would the patient accept continued cast treatment or proceed to fixation? Obtain early repeat radiographs only when the answer is that further displacement would change management. [11][20]" ], "bullets": [ "A fracture initially judged unstable merits a 1- to 2-week radiograph if redisplacement would trigger surgery. [20]", "For stable fractures, routine radiographs before cast removal are not required unless clinical concern arises. [20]" ] } ], "table": { "caption": "Post-reduction treatment selection for adult Colles fracture. [18][4][20][23]", "columns": [ "Clinical branch", "Key discriminator", "Preferred pathway" ], "rows": [ [ "Non-geriatric adult", "Radial shortening >3 mm, dorsal tilt >10 degrees, or intra-articular step-off >2 mm after reduction. [18]", "Discuss operative fixation. [18]" ], [ "Geriatric adult with acceptable function goals", "Radiographic deformity alone; long-term patient-reported outcomes are not superior with surgery. [18]", "Closed reduction when indicated, then immobilization and functional follow-up. [18][4]" ], [ "Older but high-demand patient", "Functional demand and quality of reduction are central to decision-making. [4]", "Individualize fixation versus casting after counseling on earlier recovery potential and surgical risk. [11][14]" ], [ "Stable or minimally displaced extra-articular fracture", "No need for reduction or acceptable post-reduction alignment. [13][21][23]", "Immobilize nonoperatively; avoid unnecessary surveillance imaging. [20]" ], [ "Unstable fracture in which redisplacement would change treatment", "Anticipated loss of reduction has actionable consequences. [20]", "Repeat radiograph at 1 to 2 weeks and proceed according to alignment and patient goals. [20]" ] ] } }, { "id": "nonoperative-management", "eyebrow": "Casting Pathway", "heading": "Structure immobilization and radiographic follow-up around the risk of actionable displacement", "intro": "Immobilization should protect reduction without prolonging stiffness-producing treatment.", "paragraphs": [ "Closed reduction and plaster immobilization remain the primary noninvasive approach for extra-articular distal radius fractures. Immobilization commonly lasts 3 to 6 weeks, but non- or minimally displaced fractures that did not require reduction may safely undergo only 1 week of plaster immobilization in selected patients; shorter immobilization may improve function and return to daily activities. [13][21]", "For a stable fracture, consider cast removal at 4 weeks to permit early mobilization. Do not obtain an x-ray solely at cast removal unless symptoms or examination create concern; routine repeat imaging is reserved for unstable patterns in which a changed position would lead to surgical intervention. [20]", "At each cast or splint assessment, ask specifically about escalating pain, numbness or tingling, and finger color change. These findings require immediate examination of the immobilization and neurovascular status rather than reassurance or delayed routine follow-up. [22]" ], "bullets": [ "Use a 1- to 2-week x-ray after injury or manipulation only for an unstable pattern when redisplacement would change the plan. [20]", "Consider 4-week cast removal for stable fractures to enable early mobilization. [20]", "For non- or minimally displaced fractures without reduction, a short immobilization course may be appropriate in selected patients. [13]" ], "subsections": [], "table": { "caption": "Imaging and immobilization decisions after nonoperative treatment. [13][20]", "columns": [ "Situation", "Imaging plan", "Immobilization decision" ], "rows": [ [ "Unstable fracture; further displacement would prompt surgery", "Repeat wrist radiograph 1 to 2 weeks after injury or manipulation. [20]", "Continue immobilization while reassessing alignment and surgical preference. [20]" ], [ "Stable fracture", "No routine follow-up x-ray required; no x-ray at cast removal unless clinically indicated. [20]", "Consider cast removal at 4 weeks for early mobilization. [20]" ], [ "Non- or minimally displaced fracture not requiring reduction", "Routine imaging strategy should be guided by clinical concern. [13][20]", "Selected patients may have 1 week of plaster immobilization. [13]" ] ] } }, { "id": "operative-management", "eyebrow": "Fixation", "heading": "Choose fixation for reduction goals, fracture morphology, and recovery priorities", "intro": "Fixation improves stability and may accelerate recovery, but long-term functional advantages are not uniform.", "paragraphs": [ "When operative stabilization is selected, perform surgery within 72 hours for intra-articular distal radius fractures and within 1 week for extra-articular fractures. More displaced and unstable fractures generally warrant open reduction and internal fixation, while simpler patterns may be treated with percutaneous K-wires; external fixation is an additional option in selected patterns. [20]", "Volar locking plate fixation provides stable fixed-angle support, direct reduction, and permits early active wrist rehabilitation. It is particularly useful for comminuted fractures, osteopenic bone, and high-energy injuries, but its principal patient-centered advantage is earlier functional recovery in unstable or high-demand cohorts; longer-term outcomes may converge with nonoperative care. [15][11]", "Counsel specifically about plate-related complications before choosing volar fixation. Reported complications include flexor and extensor tendon injury, flexor pollicis longus rupture, carpal tunnel syndrome, complex regional pain syndrome, loss of reduction, and hardware failure. New pain, tendon dysfunction, median neuropathy, or concern for mechanical failure after fixation should trigger focused examination and radiographic assessment. [14]" ], "bullets": [ "Use percutaneous pinning for simpler fracture patterns when percutaneous reduction and stabilization are adequate. [20]", "Use volar locking plate fixation when direct reduction and stable fixation are needed for a displaced, unstable, comminuted, or osteopenic fracture. [15][20]", "Do not frame surgery as automatically superior in older adults; weigh earlier recovery against operative complications and similar long-term reported outcomes. [18][11][14]" ], "subsections": [], "table": { "caption": "Definitive stabilization options and principal selection tradeoffs. [15][20][14]", "columns": [ "Option", "Most useful setting", "Principal tradeoff" ], "rows": [ [ "Closed reduction and cast immobilization", "Stable or acceptably reduced fractures; often favored in geriatric patients with lower functional demand. [4][18][21]", "Least complications but may produce worse radiographic alignment than surgery. [4]" ], [ "Percutaneous K-wire fixation", "Simpler fracture patterns suitable for percutaneous stabilization. [20]", "Less suitable when fracture complexity requires direct reduction or more robust fixation. [20]" ], [ "Volar locking plate fixation", "Displaced, unstable, comminuted, osteopenic, or high-demand injuries requiring stable fixation and early rehabilitation. [15][20]", "Risk of tendon injury or rupture, median neuropathy, complex regional pain syndrome, loss of reduction, and hardware failure. [14]" ], [ "External fixation", "An operative option for selected distal radius fracture patterns. [20]", "Requires selection based on morphology and treatment goals; no uniform long-term functional superiority is established across techniques. [20][21]" ] ] } }, { "id": "follow-up-and-complications", "eyebrow": "Surveillance", "heading": "Monitor the complication that would change treatment", "intro": "Follow-up should detect loss of reduction, neurovascular compromise, and treatment-specific dysfunction.", "paragraphs": [ "For nonoperative care, the highest-yield surveillance question is whether a fracture likely to redisplace remains acceptably aligned when a change would lead to fixation. Schedule the 1- to 2-week radiograph only in that circumstance; stable fractures can proceed toward early mobilization after cast removal without routine imaging. [20]", "After volar plating, evaluate new volar wrist pain, thumb-flexion weakness or loss, extensor dysfunction, paresthesias, disproportionate pain, and mechanical symptoms as possible tendon injury, flexor pollicis longus rupture, carpal tunnel syndrome, complex regional pain syndrome, or hardware failure. These complications are recognized risks of plate fixation and should prompt targeted surgical reassessment rather than routine observation. [14]", "Functional recovery should be assessed against the patient's hand-use requirements rather than radiographs alone. In older adults, a less anatomic radiographic result after casting may still yield function comparable to surgery, while a high-demand patient may reasonably value the earlier recovery permitted by stable operative fixation. [4][11][15]" ], "bullets": [ "Reassess alignment early only if a loss of reduction would alter the definitive plan. [20]", "Escalate after plating for suspected tendon dysfunction, median neuropathy, complex regional pain syndrome, loss of reduction, or hardware failure. [14]", "Use patient-specific functional demand as the final arbiter when radiographic and patient-reported outcomes diverge. [4][18]" ], "subsections": [], "table": { "caption": "Follow-up findings that require a change in management. [20][14][22]", "columns": [ "Finding", "Likely concern", "Action" ], "rows": [ [ "Interval displacement on x-ray in an unstable fracture", "Failure to maintain a reduction that was necessary for the patient's goals. [20]", "Reassess operative versus continued nonoperative treatment. [20]" ], [ "Severe pain, paresthesias, or digit discoloration in cast or splint", "Constrictive immobilization or evolving neurovascular compromise. [22]", "Immediate examination and correction of immobilization with repeat neurovascular assessment. [22]" ], [ "Thumb-flexion loss, tendon pain, extensor dysfunction, or median neuropathy after volar plate", "Tendon injury or rupture, carpal tunnel syndrome, or hardware-related complication. [14]", "Prompt focused assessment and surgical review. [14]" ], [ "Disproportionate persistent pain after fixation", "Complex regional pain syndrome is a recognized plate-fixation complication. [14]", "Evaluate promptly and direct management to the identified complication. [14]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "Outcomes in Older Adults With Distal Radius Fracture ...", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801347", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 2, "title": "For peer review only", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/bmjopen/7/6/e016100.draft-revisions.pdf", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com" }, { "number": 3, "title": "effectiveness of surgery versus casting for elderly patients ...", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/bmjopen/12/4/e051658.full.pdf", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com" }, { "number": 4, "title": "EULAR/EFORT recommendations for management of ...", "detail": "ard.bmj.com", "url": "https://ard.bmj.com/content/annrheumdis/76/5/802.full.pdf", "authors": "ard.bmj.com", "host": "ard.bmj.com" }, { "number": 5, 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Outcomes in Older Adults With Distal Radius Fracture ...", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801347", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by M Jayaram · 2023 · Cited by 49 — Distal radius fractures are treated nonoperatively with casting or surgically with volar locking plates (VLPs), percutaneous pinning (PP), or", "score": 0.58408195 }, { "number": 2, "title": "For peer review only", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/bmjopen/7/6/e016100.draft-revisions.pdf", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com", "snippet": "2007. 21(5): 316-22. 10. Berglund, L.M. and T.M. Messer, Complications of Volar Plate Fixation for Managing Distal Radius Fractures. J Am Acad Orthop Surg, 2009. 17(6): 369-377. 11. 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Cochrane D", "score": 0.77893573 }, { "number": 7, "title": "EULAR/EFORT recommendations for management ...", "detail": "ard.bmj.com", "url": "https://ard.bmj.com/content/76/5/802", "authors": "ard.bmj.com", "host": "ard.bmj.com", "snippet": "by WF Lems · 2017 · Cited by 224 — The treatment of displaced intra-articular distal radius fractures in elderly patients. after hip fracture achieves functional improvements: a randomized", "score": 0.72768575 }, { "number": 8, "title": "Sheet1", "detail": "bjsm.bmj.com", "url": "https://bjsm.bmj.com/content/bjsports/early/2021/08/02/bjsports-2021-103933/DC4/embed/inline-supplementary-material-4.xlsx?download=true", "authors": "bjsm.bmj.com", "host": "bjsm.bmj.com", "snippet": "The outcome of intra-articular distal radius fractures treated with fragment-specific fixation ... older adults: a randomised controlled trial", "score": 0.6737291 }, { "number": 9, "title": "Establishment and preliminary evaluation of CT-based classification for distal radius fracture | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-024-60416-9", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Inclusion criteria\n\nThe age of patients ≥ 18 years.\n\n \n\nExclusion criteria:\n\n1. (1)\n\n Fracture of bilateral distal radius;\n2. (2)\n\n Multiple injuries; multiple upper limb fractures on the same side;\n3. (3)\n\n Fractures were accompanied by related nerve and blood vessel damage;\n4. (4)\n\n The p", "score": 0.7180613 }, { "number": 10, "title": "Preferred Reporting Items for Systematic Reviews and ...", "detail": "annals.org", "url": "https://annals.org/aim/fullarticle/744664/preferred-reporting-items-systematic-reviews-meta-analyses-prisma-statement", "authors": "annals.org", "host": "annals.org", "snippet": "by D Moher · 2009 · Cited by 146718 — Loss of Reduction Following Nonoperative Management for Distal Radius Fractures. Geoffrey W. Schemitsch,; Navid Ghaderi,; Emma Cooper,; Audrey", "score": 0.52700067 }, { "number": 11, "title": "Adults Closed Distal Radial Fractures: Current Concepts in Treatment Selection and Complication Prevention", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S2589514125002063", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Fifteen studies met the inclusion criteria: three randomized controlled trials, five systematic reviews/meta-analyses, three cohort studies, two cadaveric/technical imaging studies, one guideline summary, and one narrative review. Radiographic thresholds of radial shortening >3 mm, dorsal tilt >10°,", "score": 0.528315 }, { "number": 12, "title": "Variation in surgical indications across national distal radius fracture guidelines: A comparative review", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0020138326004651", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Open access\n\n## Highlights\n\n •National DRF guidelines differ despite a shared evidence base. \n •Surgical thresholds vary and may influence treatment decisions. \n •Ulnar variance, dorsal tilt and step-off are consistent surgical markers. \n •Other predictors are inconsistently incorporated acr", "score": 0.37106878 }, { "number": 13, "title": "The past, present and future of the conservative treatment ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0020138323006162", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "2026, BMC Musculoskeletal Disorders \n ### Evolution of Concepts in the Diagnosis and Treatment of Distal Radius Fractures (Part I)\n\n2026, N.N. Priorov Journal of Traumatology and Orthopedics \n ### Functional Bracing Versus Rigid Plaster Casting for the Immobilization of Colles Fractures ", "score": 0.31548333 }, { "number": 14, "title": "Complications of Volar Plate Fixation for... : Journal of the American Academy of Orthopaedic Surgeons", "detail": "journals.lww.com", "url": "https://journals.lww.com/jaaos/abstract/00124635-200906000-00005~complications-of-volar-plate-fixation-for-managing-distal", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Volar locking plate fixation via open reduction and internal fixation is an increasingly accepted method for managing displaced distal radius fractures. Volar plating offers biomechanically stable fixation, allows early rehabilitation, and enables fixation of comminuted or osteopenic bone. The liter", "score": 0.77137923 }, { "number": 15, "title": "Volar Fixed-Angle Plating of the Distal Radius : Journal of the American Academy of Orthopaedic Surgeons", "detail": "journals.lww.com", "url": "https://journals.lww.com/jaaos/abstract/00124635-200501000-00005~volar-fixed-angle-plating-of-the-distal-radius", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "The treatment of unstable distal radius fractures continues to improve as better methods of skeletal fixation and soft-tissue management are developed. Apart from closed reduction and percutaneous pinning of simpler fracture patterns, the three main methods of management are external fixation, dorsa", "score": 0.72489023 }, { "number": 16, "title": "Complications of Volar Plate Fixation for Managing Distal ...", "detail": "journals.lww.com", "url": "https://journals.lww.com/jaaos/_layouts/15/oaks.journals/downloadpdf.aspx?an=00124635-200906000-00005", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "by LM Berglund · 2009 · Cited by 254 — Volar locking plate fixation via open reduction and internal fixation is an increasingly accepted method for managing displaced distal radius fractures.", "score": 0.6347929 }, { "number": 17, "title": "Treatment options for age-stratified distal... : International Journal of Surgery", "detail": "journals.lww.com", "url": "https://journals.lww.com/01279778-990000000-05061", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "| KW: 16 |\n| Gibbons | 1994 | United Kingdom | 9±5 | PC: 11 | 8/15 | PC: Closed reduction and cast immobilization KW: Closed reduction and percutaneous pinning with cast immobilization | Complications; reoperation rate | 6 months |\n| KW: 12 |\n| Middle-aged group |\n| Ali | 2024 | India | 37.65±11.0", "score": 0.5439058 }, { "number": 18, "title": "AAOS/ASSH Clinical Practice Guideline Summary Management of Distal Radius Fractures", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9196973", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "In summary, the distal radius fractures guideline involved reviewing over 7,100 abstracts and more than 830 full-text articles to develop 6 recommendations supported by 82 research articles meeting stringent inclusion criteria. Each recommendation is based on a systematic review of the research rela", "score": 0.7890553 }, { "number": 19, "title": "Adults Closed Distal Radial Fractures: Current Concepts in Treatment Selection and Complication Prevention - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12664365", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Over the last decade, high-quality trials and systematic reviews have refined our understanding. Although general treatment principles exist, clinical practice remains highly variable across the entire management process, from choosing between volar locking plate (VLP) fixation, external fixation (E", "score": 0.6829338 }, { "number": 20, "title": "Perioperative management of distal radius fractures", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8474299", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Not all distal radius fractures require follow-up imaging. As per BOAST guidelines, a repeat X-ray of the wrist one to two weeks after injury or manipulation is only necessary if the fracture pattern was unstable and subsequent displacement would require surgical intervention (BOAST 2017). For patie", "score": 0.66959417 }, { "number": 21, "title": "Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9712287", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Current guidelines suggest closed reduction and plaster cast immobilization as the primary treatment for extra-articular distal radius fractures because the treatment is non-invasive and cheap [11][12]. However, it is unclear if a non-invasive method also means fewer complications and an acceptable ", "score": 0.6565047 }, { "number": 22, "title": "Colles Fracture - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK553071", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "The Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture. The term Colles fracture is often used eponymously for distal fractures with dorsal angulation. These distal radius", "score": 0.5596998 }, { "number": 23, "title": "Distal Radius Fractures - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK536916", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "In addition to the above general management, there are individual guidelines and criteria for each specific type of distal radial fracture. The remainder of this section will review the specific indications for surgery or conservative management in the most common distal radial fractures, as well as", "score": 0.55449516 }, { "number": 24, "title": "Smith Fracture Review - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK547714", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Introduction\n\nSmith fracture is an eponym for a distal radius fracture with volar displacement or angulation of the distal fragment. This condition is also known as a reverse Colles fracture since the more common Colles fracture features a dorsally displaced distal fracture fragment (see Image. C", "score": 0.3935487 } ], "publishedAt": "2026-08-24T17:42:43.673668+00:00", "updatedAt": "2026-08-24T17:42:43.673668+00:00", "readingMinutes": 6, "slug": "colles-fracture" }